2018 Fl Smmc Referral Quiz

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2018 Fl Smmc Referral Quiz - Quiz

Referral Quiz


Questions and Answers
  • 1. 

    Select the scenario where the caller should be referred to DCF.

    • A.

      • I want to request another Medicaid Gold Card.

    • B.

      • I want to request transportation services.

    • C.

      • I need to change my Primary Care doctor.

    • D.

      • I have straight Medicaid and need to find a dentist.

    Correct Answer
    A. • I want to request another Medicaid Gold Card.
    Explanation
    The scenario where the caller should be referred to DCF is when they want to request another Medicaid Gold Card. This suggests that there may be an issue with their current card or they require a replacement, which is a matter that would be handled by the Department of Children and Families (DCF).

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  • 2. 

    "My baby was just born and I need to activate his Medicaid. Who should I call?"

    • A.

      • DCF

    • B.

      • SSA

    • C.

      • AHCA Medicaid Helpline

    • D.

      • The Health Plan

    Correct Answer
    A. • DCF
    Explanation
    DCF, or the Department of Children and Families, is the correct answer because they are responsible for administering Medicaid for children and families in many states. They can provide information and assistance on how to activate Medicaid for a newborn baby. The SSA, AHCA Medicaid Helpline, and The Health Plan may be able to provide some information or guidance, but DCF is the appropriate agency to contact for this specific situation.

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  • 3. 

    "Where can I get another Medicaid Gold Card?"

    • A.

      • SSA

    • B.

      • AHCA Medicaid Helpline

    • C.

      • SMMC Help Line

    • D.

      • DCF

    Correct Answer
    D. • DCF
    Explanation
    The correct answer is DCF. DCF stands for the Department of Children and Families, which is a government agency that provides assistance and support to families and individuals in need. They are responsible for managing the Medicaid program and can help individuals obtain a new Medicaid Gold Card. The other options listed, SSA, AHCA Medicaid Helpline, and SMMC Help Line, do not specifically deal with Medicaid card replacements.

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  • 4. 

    "My name is Dr. Smith and I need to verify the Medicaid eligibility for Jon Doe.  Where do I call?"

    • A.

      • SSA

    • B.

      • AHCA Medicaid Helpline

    • C.

      • Provider Needs Eligibility Information

    • D.

      • DCF

    Correct Answer
    C. • Provider Needs Eligibility Information
    Explanation
    The correct answer is "Provider Needs Eligibility Information" because Dr. Smith is looking to verify Medicaid eligibility for Jon Doe. The Provider Needs Eligibility Information would be the appropriate department to contact in order to obtain the necessary information.

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  • 5. 

    "I just got married and need to change my last name. Who should I call?"

    • A.

      • Office of Demographic Information

    • B.

      • DCF/SSA

    • C.

      • AHCA Medicaid Helpline

    • D.

      • SMMC Help Line

    Correct Answer
    B. • DCF/SSA
    Explanation
    When getting married and needing to change your last name, you should call the DCF/SSA. The DCF stands for the Department of Children and Families, and the SSA stands for the Social Security Administration. These organizations are responsible for handling name changes and updating your information in their respective systems.

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  • 6. 

    In which scenario should  the caller be referred to the AHCA Medicaid Helpline?

    • A.

      • I want to apply for Medicaid.

    • B.

      • I want to change the name on my Medicaid case.

    • C.

      • I need a list of providers that accept Straight Medicaid.

    • D.

      • I have SSI and need to update my address.

    Correct Answer
    C. • I need a list of providers that accept Straight Medicaid.
    Explanation
    The caller should be referred to the AHCA Medicaid Helpline if they need a list of providers that accept Straight Medicaid. This indicates that the caller is looking for information regarding healthcare providers who accept this specific type of Medicaid coverage. The AHCA Medicaid Helpline would be able to provide them with the necessary information and assistance in finding the appropriate providers.

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  • 7. 

    "I'm enrolled in XYZ Health Plan (HMO) and need to change my doctor.  Who do I call?"

    • A.

      • SMMC Help Line

    • B.

      • Enrollees cannot change the doctor once enrolled.

    • C.

      • AHCA Medicaid Helpline

    • D.

      • XYZ Health Plan (HMO)

    Correct Answer
    D. • XYZ Health Plan (HMO)
    Explanation
    If you are enrolled in XYZ Health Plan (HMO) and need to change your doctor, you should call XYZ Health Plan (HMO). They will be able to provide you with the necessary information and guide you through the process of changing your doctor within their network.

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  • 8. 

    "I just lost my job and need to apply for medical and food assistance.  Who should I call?"

    • A.

      • SMMC Help Line

    • B.

      • DCF

    • C.

      • AHCA Medicaid Helpline

    • D.

      • Unemployment Office

    Correct Answer
    B. • DCF
    Explanation
    The Department of Children and Families (DCF) is the appropriate agency to contact for individuals who have lost their job and need to apply for medical and food assistance. DCF provides various assistance programs, including Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP), which can help individuals in need during difficult times. They can provide information on eligibility requirements and guide the individual through the application process.

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  • 9. 

    "My purse was stolen and I need a new health plan card. Who should I call?"

    • A.

      • DCF

    • B.

      • Health Plan

    • C.

      • AHCA Medicaid Helpline

    • D.

      • SMMC Help Line

    Correct Answer
    B. • Health Plan
    Explanation
    Since the person's purse was stolen and they need a new health plan card, it would be appropriate for them to call their Health Plan. The Health Plan will be able to assist them in obtaining a replacement card and provide any necessary information or guidance related to their health plan coverage.

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  • 10. 

    I need a list of doctors affiliated with my health plan.  Who should I call?

    • A.

      • DCF

    • B.

      • Health Plan

    • C.

      • AHCA Medicaid Helpline

    • D.

      • SMMC Help Line

    Correct Answer
    B. • Health Plan
    Explanation
    The correct answer is "Health Plan". The question is asking for a list of doctors affiliated with the individual's health plan. Therefore, the individual should call their health plan to obtain this information.

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  • 11. 

    "I live in a nursing home and they stopped providing breakfast, they have not given me my meds for 2 days, and they have not changed my wound dressing for over 2 days.  Who do I report this to?"

    • A.

      • SSA

    • B.

      • AHCA Medicaid Helpline

    • C.

      • Abuse Hotline

    • D.

      • APD

    Correct Answer
    C. • Abuse Hotline
    Explanation
    The correct answer is the Abuse Hotline. The situation described in the question suggests neglect and potential abuse in the nursing home, as the person has not been provided with breakfast, medication, and proper wound care. Reporting this to the Abuse Hotline would be appropriate as they specialize in investigating and addressing cases of abuse and neglect in care facilities.

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  • 12. 

    "I need to pick one of the Obamacare plans, where should I call?"

    • A.

      • Department of Elder Affairs

    • B.

      • Agency for Healthcare Administration

    • C.

      • Social Security Administration

    • D.

      • Affordable Care Act or Obama Care

    Correct Answer
    D. • Affordable Care Act or Obama Care
    Explanation
    The correct answer is "Affordable Care Act or Obama Care". This is because the question is asking specifically about Obamacare plans, and the Affordable Care Act, also known as Obamacare, is the legislation that established these plans. The other options, such as the Department of Elder Affairs, Agency for Healthcare Administration, and Social Security Administration, are not directly related to Obamacare plans.

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  • 13. 

    Caller says: "My grandmother has passed and you all keep sending her letters about enrolling into a plan. Please stop, it makes me sad."  Where should you refer?

    • A.

      • AHCA Medicaid Helpline

    • B.

      • SSA or DCF

    • C.

      • TPL Corrections

    • D.

      • Medicare

    Correct Answer
    B. • SSA or DCF
    Explanation
    The caller is expressing their sadness and frustration about receiving letters for their deceased grandmother. The SSA (Social Security Administration) or DCF (Department of Children and Families) would be the appropriate agencies to refer the caller to in order to address this issue. These agencies can help update the necessary information and stop the letters from being sent.

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  • 14. 

    Caller says: "I just moved from Miami to Leon County. I'm still covered under the Dade County health plan and need to get my prescriptions." Where should you refer the caller?

    • A.

      • The Dade County MMA plan

    • B.

      • The Leon county MMA plan

    • C.

      • The AHCA Medicaid Helpline

    • D.

      • Leon County Pharmacy

    Correct Answer
    A. • The Dade County MMA plan
    Explanation
    The caller states that they have moved from Miami to Leon County but are still covered under the Dade County health plan. Therefore, it would be appropriate to refer the caller to the Dade County MMA plan, as that is the health plan they are currently enrolled in and would be able to assist them with getting their prescriptions.

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  • 15. 

    Caller says: "I am 85 years old and need to find out if I qualify for elderly services.  I heard the state can help older people with getting help in their home."  Where should you refer?

    • A.

      • Department of Children and Families

    • B.

      • Department of Elder Affairs

    • C.

      • Agency for Persons with Disabilities

    • D.

      • Elderly Foundation of America

    Correct Answer
    B. • Department of Elder Affairs
    Explanation
    The Department of Elder Affairs would be the appropriate referral for the caller because they specifically handle services and assistance for older people. The other options, such as the Department of Children and Families, the Agency for Persons with Disabilities, and the Elderly Foundation of America, are not specifically focused on providing services for the elderly.

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  • 16. 

    Caller says: "Someone has been using my Medicaid card to get pain medication. The pharmacy said they have filled over 10 prescriptions for a strong pain medication I don't even take. Someone is pretending to be me! " Where should you refer?

    • A.

      • Agency for Healthcare Administration

    • B.

      • Social Security Administration

    • C.

      • Medicaid Fraud Hotline

    • D.

      • Provider Eligibility Helpline

    Correct Answer
    C. • Medicaid Fraud Hotline
    Explanation
    The Medicaid Fraud Hotline is the appropriate referral in this situation because the caller suspects that someone is fraudulently using their Medicaid card to obtain pain medication. The Medicaid Fraud Hotline is specifically designed to handle reports of fraudulent activities related to Medicaid, such as identity theft or misuse of benefits. By contacting the Medicaid Fraud Hotline, the caller can report their concerns and provide any relevant information to initiate an investigation into the alleged fraud.

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  • 17. 

    Caller says: "I need to get a brochure of all plans available in my region, where can I get it?"

    • A.

      • SMMC Website

    • B.

      • Post Office

    • C.

      • DCF Office

    • D.

      • Clerk of Court Office

    Correct Answer
    A. • SMMC Website
    Explanation
    The correct answer is the SMMC website. The caller is looking for a brochure of all plans available in their region, and the SMMC website is likely to have this information readily available. It is a common practice for organizations to provide brochures and informational materials on their website for easy access by the public. Therefore, the SMMC website would be the most convenient and efficient option for the caller to obtain the desired brochure.

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  • 18. 

    "I just found out that I 'm pregnant and I need to apply for Pregnancy Medicaid." Where should you refer?

    • A.

      • Healthy Babies and Children

    • B.

      • Florida Moms Association

    • C.

      • AHCA Medicaid Helpline

    • D.

      • Department of Children and Families

    Correct Answer
    D. • Department of Children and Families
    Explanation
    The Department of Children and Families is the appropriate place to refer someone who needs to apply for Pregnancy Medicaid. They handle various social welfare programs, including Medicaid, and can provide assistance and guidance in applying for benefits specifically related to pregnancy.

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  • 19. 

    The caller states her child has autism and needs information on the APD waiver, where should you refer?

    • A.

      • Department of Elder Affairs

    • B.

      • Agency for Healthcare Administration

    • C.

      • Department of Children and Families

    • D.

      • Agency for Persons with Disabilities

    Correct Answer
    D. • Agency for Persons with Disabilities
    Explanation
    The caller is seeking information on the APD waiver for her child with autism. The correct answer is the Agency for Persons with Disabilities, as they are responsible for providing services and support to individuals with disabilities in Florida. The Department of Elder Affairs focuses on services for the elderly, the Agency for Healthcare Administration oversees healthcare services, and the Department of Children and Families deals with child welfare and family services.

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  • 20. 

    The caller states they need another MediKids blue card.  Where should you refer?

    • A.

      • MediKids

    • B.

      • KidCare

    • C.

      • DCF

    • D.

      • SSA

    Correct Answer
    A. • MediKids
    Explanation
    The caller states they need another MediKids blue card. The correct answer is MediKids because the caller specifically mentions needing another MediKids blue card. This suggests that they are already familiar with the MediKids program and are seeking assistance or information related to it. Therefore, referring them to MediKids would be the appropriate course of action.

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  • 21. 

    The caller wants to find out if a mouth guard is covered under her plan for children's dental.  Where should you refer?

    • A.

      APD

    • B.

      • DCF

    • C.

      • AHCA

    • D.

      • Health Plan

    Correct Answer
    D. • Health Plan
    Explanation
    The caller should refer to the Health Plan to find out if a mouth guard is covered under her plan for children's dental. The Health Plan is responsible for providing information about the coverage and benefits available under the caller's specific plan. They will be able to answer any questions regarding coverage for dental services, including whether or not a mouth guard is covered.

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  • 22. 

    The caller needs to find out about Medicare prescription coverage.  Where should you refer?

    • A.

      • SSA

    • B.

      • Medicare

    • C.

      • DCF

    • D.

      • AHCA

    Correct Answer
    B. • Medicare
    Explanation
    The caller needs information about Medicare prescription coverage, so the appropriate place to refer them would be Medicare. Medicare is the federal health insurance program that provides coverage for individuals aged 65 and older, as well as certain younger individuals with disabilities. They would be able to provide the caller with the necessary information regarding Medicare prescription coverage.

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  • 23. 

    The caller needs to update a private insurance on their case.  Where should you refer?

    • A.

      • SSA

    • B.

      • DCF

    • C.

      • AHCA

    • D.

      • Third Party Liability

    Correct Answer
    D. • Third Party Liability
    Explanation
    The caller needs to update a private insurance on their case. Third Party Liability refers to situations where someone other than the patient is responsible for paying for the medical expenses. In this case, the private insurance would fall under Third Party Liability, as it is not the patient themselves who will be responsible for paying for the medical expenses.

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  • 24. 

    The caller has questions about how Share of Cost works, where should you refer?

    • A.

      • SSA

    • B.

      • AHCA

    • C.

      • DCF

    • D.

      • DOEA

    Correct Answer
    C. • DCF
    Explanation
    If the caller has questions about how Share of Cost works, they should be referred to the Department of Children and Families (DCF). DCF is responsible for administering programs and services related to child welfare, economic assistance, and social services in many states. They would have the necessary information and resources to explain how Share of Cost works and provide guidance to the caller.

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  • 25. 

    The caller has questions about their Medicare Advantage Plan, where should they call?

    • A.

      • SSA

    • B.

      • DOEA

    • C.

      • Medicare

    • D.

      • AHCA

    Correct Answer
    C. • Medicare
    Explanation
    The caller should call Medicare for questions about their Medicare Advantage Plan.

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  • 26. 

    The caller wants to find out if they qualify for an SSI check because they have a disability, where should they call?

    • A.

      • SSA

    • B.

      • AHCA

    • C.

      • DCF

    • D.

      • APD

    Correct Answer
    A. • SSA
    Explanation
    The caller should call SSA (Social Security Administration) to find out if they qualify for an SSI check because they have a disability. SSA is responsible for administering the SSI program and determining eligibility for benefits based on disability.

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  • 27. 

    The caller needs to change the direct service provider, who should they call?

    • A.

      • AHCA

    • B.

      • Plan Care Coordinator

    • C.

      • CARES Team

    • D.

      • DOEA

    Correct Answer
    B. • Plan Care Coordinator
    Explanation
    If the caller needs to change their direct service provider, they should call the Plan Care Coordinator. The Plan Care Coordinator is responsible for coordinating and managing the care of individuals enrolled in a specific healthcare plan. They have the authority to help the caller with any changes they need to make regarding their service provider.

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  • 28. 

    The caller needs a Certificate of Creditable Coverage, who should they call?

    • A.

      • AHCA Medicaid Helpline

    • B.

      • DCF

    • C.

      • DOEA

    • D.

      • SSA

    Correct Answer
    A. • AHCA Medicaid Helpline
    Explanation
    The correct answer is AHCA Medicaid Helpline. The caller needs a Certificate of Creditable Coverage, which is a document that proves the individual had health insurance coverage in the past. The AHCA Medicaid Helpline is the most appropriate contact to obtain this certificate as they deal with Medicaid-related matters and can provide the necessary information and assistance. DCF, DOEA, and SSA are not directly related to Medicaid or the issuance of Certificates of Creditable Coverage.

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  • 29. 

    The caller needs information on senior health and wellness programs, who should they call?

    • A.

      • CARES

    • B.

      • DCF

    • C.

      • AHCA

    • D.

      • DOEA

    Correct Answer
    D. • DOEA
    Explanation
    The caller should call DOEA (Department of Elder Affairs) for information on senior health and wellness programs.

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  • 30. 

    I need to establish my Level of Care to see if I qualify for LTC, who do I call to do that?

    • A.

      DCF

    • B.

      AHCA

    • C.

      DOEA

    • D.

      Medicare Questions

    Correct Answer
    C. DOEA
    Explanation
    To establish the Level of Care and determine eligibility for Long-Term Care (LTC), the appropriate authority to contact is the Department of Elder Affairs (DOEA). They specialize in providing services and support for older adults, including assessing their care needs and determining if they qualify for LTC. The DOEA is knowledgeable about the specific criteria and requirements for LTC, making them the best resource to call for assistance in this matter.

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